Objective Little is known about the effects of antioxidant on the micturition function in diabetic cystopathy .In this study, we investigated the effects of antioxidant sulforaphane on bladder micturition function in diabetes mellitus ( DM)mice with bladder underactivity . Met hods We established DM models in mice by intraperitoneal injection of a single dose of streptozotocin (STZ)at 65 mg/kg and randomly divided them into three groups , sulforaphane treatment (n=10), vehicle treatment (n=10), and DM model (n=10), with another 10 normal healthy mice included as blank controls.At 24 weeks of the experiment, we obtained and analyzed such indexes of mice as the body weight , fasting blood glucose (FBG), 24-hour urine volume (24 h UV) and bladder wet weight ( BWW ) , results of cystometrography , and cystometric parameters including intercontraction interval ( ICI ) , maximum bladder pressure during micturition ( Pmax ) , maximum cystometric capacity (MCC), void volume (VV), post-void residual urine vol-ume (PVR) and residual urine rate (RUR). Results Compared with the blank controls , the DM models with bladder underactivity showed significantly increases in BWW ([67.96 ±2.35]mg), 24 h HU ([22.47 ±1.93]mL), MCC ([0.70 ±0.03]mL), VV (0[.23 ±0.01]mL), PVR ([0.49 ±0.02]mL), RUR ([70.10 ± 0.80]%), and ICI, but a remarkable decrease in Pmax .Sulforaphane treatment significantly reduced BWW ([576.9 ±2.41]mg), 24 h HU ([16.27 ±1.51] mL), MCC ([0.54 ±0.03]mL), PVR ([0.34 ±0.02]mL), RUR ([62.71 ±1.26]%), and ICI of the diabetic mice . Conclusion Sulforaphane could improve bladder micturition function in mice with STZ-induced DM , which might be related to its action mechanism of antioxidative stress damage .

Objective:To preliminarily examine the feasibility and outcome of single-port laparoscopic radical prostatectomy with full-length urethral preservation (FLUP-SPRP).Method:This study was a prospective case series study. A total of 25 patients with prostate cancer who met the enrollment criteria and agreed to this surgical procedure from March 2022 to December 2022 were collected at the Department of Urology, the Second Affiliated Hospital of Nanjing Medical University. The age of the patients was (67.2±7.6) years (range: 61 to 76 years). This novel procedure was performed by an experienced surgeon who performed single hole radical prostatectomy skillfully. Patient urinary control, tumor control, and related surgical complications after surgery were regularly monitored. Postoperative urinary control was evaluated using the daily amount of urine pad, 0 to 1 piece of urine pad was to restore urinary control, and 0 to 1 piece of pad within 24 hours after catheter removal was immediate urinary control.Result:All prodecures were successfully completed without transit to open surgery. The surgical time was (128.4±22.4) minutes (range: 100 to 145 minutes), the intraoperative blood loss was (68.2±13.7) ml (range: 50 to 120 ml). The urethral injury occurred in 4 cases during surgery and was repaired by sutures. The urinary control recovery rates within 24 hours, 1 week, 4 weeks, and 7 weeks after surgery were 80.0%, 84.0%, 92.0% and 100%, respectively. Postoperative large section pathology revealed 1 case with a positive basal margin of the prostate and negative margins of all prostate glands around the urethra. Postoperative complications included urinary tract infection in 3 cases, urodynia in 2 cases, and acute urinary retention in 1 case. MRI follow-up 3 months after surgery showed normal anatomy of the bladder and urethra. The follow-up values of prostate specific antigen at 3 and 6 months after surgery were less than 0.1 μg/L.Conclusions:The preliminary results of this study indicate that the FLUP-SPRP procedure is safe and feasible. The early results of postoperative urinary control and oncology are as expected.

Objective:To preliminarily examine the feasibility and outcome of single-port laparoscopic radical prostatectomy with full-length urethral preservation (FLUP-SPRP).Method:This study was a prospective case series study. A total of 25 patients with prostate cancer who met the enrollment criteria and agreed to this surgical procedure from March 2022 to December 2022 were collected at the Department of Urology, the Second Affiliated Hospital of Nanjing Medical University. The age of the patients was (67.2±7.6) years (range: 61 to 76 years). This novel procedure was performed by an experienced surgeon who performed single hole radical prostatectomy skillfully. Patient urinary control, tumor control, and related surgical complications after surgery were regularly monitored. Postoperative urinary control was evaluated using the daily amount of urine pad, 0 to 1 piece of urine pad was to restore urinary control, and 0 to 1 piece of pad within 24 hours after catheter removal was immediate urinary control.Result:All prodecures were successfully completed without transit to open surgery. The surgical time was (128.4±22.4) minutes (range: 100 to 145 minutes), the intraoperative blood loss was (68.2±13.7) ml (range: 50 to 120 ml). The urethral injury occurred in 4 cases during surgery and was repaired by sutures. The urinary control recovery rates within 24 hours, 1 week, 4 weeks, and 7 weeks after surgery were 80.0%, 84.0%, 92.0% and 100%, respectively. Postoperative large section pathology revealed 1 case with a positive basal margin of the prostate and negative margins of all prostate glands around the urethra. Postoperative complications included urinary tract infection in 3 cases, urodynia in 2 cases, and acute urinary retention in 1 case. MRI follow-up 3 months after surgery showed normal anatomy of the bladder and urethra. The follow-up values of prostate specific antigen at 3 and 6 months after surgery were less than 0.1 μg/L.Conclusions:The preliminary results of this study indicate that the FLUP-SPRP procedure is safe and feasible. The early results of postoperative urinary control and oncology are as expected.

Objective To compare the outcomes between interstitial cystitis/bladder pain syndrome (IC/BPS)patients treated with three-drug combination (M blockers + alpha blockers + Amitriptyline) and Sodium hyaluronate intravesical instillation.Methods The patients who came to Second Affiliated Hospital of Nanjing Medical University during October 2014 to September 2015 were investigated if they had IC/BPS.According to the treatment plan,27 patients (group A) received three-drug combination (M blocker + alpha blockers + Amitriptyline)therapy.Thirty-eight patients recelved instillation of sodium hyaluronate (40 mg/50 ml) therapy (group B).Intravesical instillations were performed weekly in the first 6 weeks,and monthly until sixth month.Interstitial cystitis symptom index,interstitial cystitis problem index,overactive bladder symptom score,visual analogue scale/score,the maximum urination and self-rating depression scale were assessed at baseline and the sixth month.Measurement data were expressed as ((x) ±s),t test was used for comparison between groups,and paired t-test was used for comparison of paired data.Results There were 65 patients.Age range was 25-73 years,course of disease (2-99 months),average age (51.4 ± 13.5),average duration (39.8 ± 31.0) months,of which 9 male (13.8％) and 56 female (86.2％) patients.The group A variation of ICSI、ICPI、OABSS、VAS、SDS and maximum urination were 3.7 ± 2.4、1.3 ± 1.5、1.2 ± 1.3、2.1 ± 1.5、3.1 ± 4.5、74.6 ± 52.4,The variation of group B ware 6.8 ± 3.6、5.0 ± 3.8、2.5 ± 1.8、2.8 ± 1.7、8.9 ± 6.4、109.0 ± 81.1.The improvement in ICSI,ICPI,OABSS,SDS of group B were higher than group A (P ＜ 0.05).Conclusion IC/BPS seriously affect the quality of life and the patients are prone to depression.The sodium hyaluronate intravesical instillation therapy could achieve more effect than the three-drug combination therapy.

Background:Gastroesophageal reflux disease(GERD)is a common digestive system disease with typical symptoms of acid reflux and heartburn,and high sensitivity of esophagus is an important cause of heartburn and other symptoms.TRPV1 and NaV1.8 may play an important role in the regulation of esophageal hypersensitivity,and the specific mechanism is not yet clear.Aims:To detect the expression levels of TRPV1 and NaV1.8 in esophageal sensory neuron in GERD state and explore their role in mediating esophageal hypersensitivity.Methods:Twelve guinea pigs were randomly divided into control group and GERD group.The GERD guinea pig model was established by drinking hydrochloric-pepsinogen acid water,the body mass of guinea pigs was monitored,the esophageal inflammatory histological score was performed,and the successful construction of the GERD model was verified by measuring the expression indicators of inflammatory factors.The heart rate variability method was used to detect whether the guinea pigs were in the state of visceral hypersensitivity.The expression and co-expression of TRPV1 and NaV1.8 in esophagus,nodular ganglion and jugular ganglion were detected by immunofluorescence,Western blot and real-time fluorescence quantification.Results:Compared with the control group,the score of esophageal inflammatory histology in GERD group was much higher than that in the control group(0.96 vs.0.22).The contents of esophageal inflammatory factors interleukin(IL)-1β,IL-6 and tumor necrosis factor(TNF)-α were significantly increased(P<0.05),while the contents of anti-inflammatory factor IL-10 were decreased(P<0.05).The index of heart rate variability,low frequency to high frequency ratio(LF/HF)had no significant difference between the GERD group and the control group(P>0.05),and the LF/HF in the GERD group was higher than that in the control group after the molding(P<0.05).In esophagus and jugular,the expression levels of TRPV1 and NaV1.8 in GERD group were increased and the co-expression levels were up-regulated(P<0.05),while the expression levels in nodose were not significantly changed(P>0.05).Conclusions:In the case of esophageal acid exposure,the expression levels of TRPV1 and NaV1.8 in the esophageal mucosal epithelium increased,while the expression levels in jugular ganglion were up-regulated,thus promoting the transmission of pain signals in the vagus nerve pathway,and ultimately leading to the occurrence of esophageal hypersensitivity.

Gastroesophageal reflux disease (GERD) is a common digestive disease characterized by heartburn and acid reflux. In recent years, many studies have shown that esophageal hypersensitivity is an important pathophysiological mechanism involved in the occurrence and development of heartburn. Esophageal sensory receptors including transient receptor potential vanilloid 1 (TRPV1), prostaglandin E

Objective:To investigate the safety and efficacy of sacral neuromodulation(SNM)therapy for the treatment of lower urinary tract dysfunction(LUTD)in elderly patients.Methods:Clinical data of 91 elderly patients with LUTD from multiple medical institutions who received SNM during the period from January 2012 to December 2016 were retrospectively analyzed.Patients were divided into four groups: the interstitial cystitis(IC)group(n=28), the neurogenic bladder(NB)group(n=36), the overactive bladder syndrome(OAB)group(n=13)and the idiopathic dysuria(ID)group(n=14). Different sets of evaluation parameters were used for different diseases.Patients’ baseline data and data in stage I(test phase)and stage Ⅱ(permanent SNM)were recorded, statistically analyzed and compared.Results:Ninety-one people underwent SNM treatment.Of them, 53 patients received permanent implants(stage Ⅱ), and the total conversion rate of stage I to stage Ⅱ was 58.2%(53/91). Patients receiving permanent implants(stage Ⅱ)had a preoperative period ranging from 3 months to 30 years, and were followed up for 2 to 58 months after treatment, with an average follow-up of 19.6 months.The improvement rates in stage I for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 35.4%, 31.6%, 33.7%, 32.6%, 49.2%, 43.2% and 13.2%, respectively.The improvement rates in stage Ⅱ for urinary urgency, daily urination frequency, daily nocturnal urination frequency, maximum urine volume, daily average urine volume, daily urine leakage frequency, and quality of life score were 43.2%, 40.0%, 37.8%, 50.5%, 70.5%, 70.4% and 43.2%, respectively.Three adverse events occurred, including 1 case of recurrent symptoms, 1 case of moderate infection, and 1 case of electrical lead dislocation.Conclusions:Sacral nerve stimulation has definitive and consistent curative effects on LUTD in elderly people.The follow-up time should be extended to further study the safety of sacral nerve stimulation.